AB0689 LIFESTYLE AND NUTRITIONAL STATUS IN ITALIAN PATIENTS WITH ISOLATED SJӦGREN’S SYNDROME
Authors: R. Izzo, S. Colafrancesco, A. Gattamelata, A. Pinto, L. M. Donini, G. Guggino, G. Grasso, M. Matucci-Cerinic, M. Orlandi, S. De Vita, L. Quartuccio, M. Binutti, F. Conti, R. Priori
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Dietary habits and Physical Activity (PA) are two pivotal features of healthy life in terms of the prevention and treatment of metabolic and chronic disease <sup>[1]</sup>. Few data are available concerning these issues in isolated Sjӧgren's syndrome (SS) patients <sup>[2]</sup>. <h3>Objectives</h3> Aim of the study was to assess the level of PA, the adherence to Mediterranean diet (MD) and the nutritional status of Italian patients with SS. <h3>Methods</h3> Consecutive patients with SS (AECG criteria 2002) were enrolled. For each patient ESSDAI, ESSPRI, SSDDI were calculated. The value of focus score was obtained in the minor salivary gland biopsy (MSG), when performed. The International Physical Activity Questionnaire (IPAQ) was administered to assess the level of physical activity; the Mediterranean Diet (MDiet) score <sup>[3]</sup> was employed to analyse adherence to Mediterranean diet (the score spans from 0 - no adherence - to 55 - maximum adherence). In a subgroup of 26 patients, the dietary habits were evaluated with a daily food diary. Sarcopenia, a muscle failure that accrue across a lifetime, was identified by a diagnostic algorithm <sup>[4]</sup> with age-differentiated cut-offs; the Hand Grip test (HGT) and the Chair Stand test (CST) were used as screening tests, the Dual Energy X-ray Absorptiometry (DEXA) was employed to confirm and to quantify Appendicular Skeletal Mass (ASM, kg/m<sup>2</sup>). The muscular performance (6-minutes Walking Test – 6MWT) was measured to grading sarcopenia. Statistical analysis was performed with SPSS. <h3>Results</h3> The 130 pSS patients enrolled showed a moderate adherence to the Mediterranean Diet (median MDiet = 33, third quintile) and played a moderately PA (median MET x min/wk in the second tertile). No significant associations were found between BMI, PA, MDiet and clinimetric index of pSS (ESSDAI, ESSPRI, SSDDI). BMI was higher in older patients (R <sup>2</sup> 0.96, p 0.02). 16 out of the 26 subjects of the subgroup (61%) showed a reduction in muscle strength (HGT and/or CST) and therefore a condition of probable sarcopenia but only 6 (23%) subjects were found to be sarcopenic (ASM). Only one sarcopenic patient had a 6MWT less than 10% of the predicted value and a reduced PA in MET x min/wk. Patients' daily diet consisted of 43% of total energy coming from carbohydrate, fat represented 40% of total energy intake, the remaining 17% daily energy coming from proteins. Fat consumption is higher and complex carbohydrates intake is lower compared to the levels of energy and nutrient intake for the Italian population <sup>[5]</sup>. <h3>Conclusion</h3> This preliminary study considering Italian women with SS shows a moderate adherence to the MD similar to what previously reported in the general female population in Europe (32.5 ± 5 DS) <sup>[6]</sup>. Moreover, considering the results obtained in the subgroup, SS patients seem to have an unbalanced diet because of an intake of fat foods higher than that recommended in the Mediterranean Diet. A possible explanation for the higher fats intake may be a lubricating effect aiding mastication and swallowing. It can be hypothesized that an unbalanced diet might be partly responsible for increasing chronic damage and the associated reduction in muscle mass. <h3>References</h3> [1]Bonofiglio, Nutrients 2022 [2]Ng, Rheumatol Int, 2017 [3]Panagiotakos, J Med Food, 2007 [4]Cruz-Jentoft, 2019 [5]LARN 2014 [6]Fallazize, Nutrients 2018 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.